扶正化瘀片联合恩替卡韦对乙肝肝硬化患者肝纤维化及腹水指标的影响

Clinical Observation on Effect of Therapy of Fuzheng Huayu Tablets Combined with Entecavir on Liver Fibrosis and on Indexes of Ascites in Patients with Hepatitis B Cirrhosis

目的:探讨扶正化瘀片联合恩替卡韦对乙肝肝硬化患者肝纤维化的改善作用以及腹水中葡萄糖(GLU)和乳酸脱氢酶(LDH)水平的影响。方法:将慢性乙型肝炎肝纤维化患者278例以随机数字表法分为观察组和对照组各139例。对照组予恩替卡韦分散片治疗。观察组在对照组基础上予扶正化瘀片。2组疗程均24周。比较2组肝纤维化、疗效、乙型肝炎病毒(HBV)转阴率以及腹水中GLU和LDH水平。结果:治疗后,2组肝纤维化指标[透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、层黏蛋白(LN)]减少(P <0.01);观察组治疗后肝纤维化指标低于对照组(P <0.01)。治疗后,观察组总有效率95.68%,高于对照组的89.21%(P <0.05)。治疗24周后,观察组HBsAg转阴率、HBeAg转阴率、HBV-DNA转阴率分别74.82%、61.15%、78.42%,对照组为61.15%、48.20%、64.03%,2组比较,差异有统计学意义(P <0.05)。治疗后,2组腹水LDH及GLU水平降低(P <0.01);观察组治疗后腹水LDH及GLU水平低于对照组(P <0.01)。结论:扶正化瘀片联合恩替卡韦治疗乙肝肝硬化疗效明显,且可降低腹水中GLU和LDH水平。

Objective:To investigate the effect of Fuzheng Huayu tablets combined with Entecavir on the improvement of liver fibros is in patients with hepatitis B cirrhosis and its effect on levels of glucose(GLU)and lactate dehydrogenase(LDH)in ascites.Methods:A total of 278 patients with chronic hepatitis B with liver fibrosis were divided into the observation group and the control group according to the random number table method,139 cases in each group.The control group received Entecavir Dispersible tablets,and the observation group was additionally treated with Fuzheng Huayu tablets based on the treatment of the control group.Both groups were treated for 24 weeks.The levels of liver fibrosis,therapeutic effect,negative conversion rate of hepatitis b virus(HBV)and the levels GLU and LDH in ascites were compared between the two groups.Results:After treatment,the levels of the indexes of liver fibrosis including hyaluronic acid(HA),procollagenⅢ(PCⅢ),collagenⅣ(Ⅳ-C),Laminin(LN)in the two groups were decreased(P<0.01),and the level of liver fibrosis in the observation group was lower than that in the control group(P<0.01).After treatment,the total effective rate in the observation group was 95.68%,higher than that of 89.21%in the control group(P<0.05).After 24 weeks of treatment,the HBsAg negative conversion rate,the HBeAg negative conversion rate and the HBV-DNA negative conversion rate were74.82%,61.15%,78.42%respectively in the observation group,and 61.15%,48.20%,64.03%respectively in the control group,the difference being significant(P<0.05).After treatment,the levels of LDH and GLU in ascites in both groups were decreased(P<0.01),and the two levels in the observation group were lower than those in the control group(P<0.01).Conclusion:The therapy of Fuzheng Huayu tablets combined with Entecavir is effective in the treatment of hepatitis B cirrhosis,and can reduce the levels of GLU and LDH in ascites.